The differential diagnosis of the type of tonsil mass that was found in the present case includes several kinds of malignant neoplasms. The most common malignancy that occurs in the tonsil or tonsillar fossa is squamous cell carcinoma, accounting for 90% of oropharyngeal tumors.1 The second most common is lymphoma, especially in the palatine tonsils or base of the tongue. Other primary malignancies of the oropharynx include melanoma, minor salivary gland cancer, small cell carcinoma, and sarcoma. Metastases also occur in the tonsil from a wide variety of primary tumors occurring throughout the body.